Building world leading surgical oncology for gastric cancer in China / 中华外科杂志

This century has seen significant advances in the treatment and research of gastric cancer in China. Chinese scholars have made a series of key technological breakthroughs in minimally invasive surgery, perioperative treatment and artificial intelligence diagnosis. These world-leading clinical researches have improved treatment outcomes and reduced surgical trauma. Global surveillance of trends in cancer survival 2000-14 reported that survival of gastric cancer in China has significantly improved during the last 20 years. This paper reviews the research history of surgical oncology for gastric cancer in China, summarises the experience and attempts to explore the future direction.

Adult cerebral hepatolenticular degeneration: report of one case with literature review / 中华全科医师杂志

A 26-year-old male presented with tremor of bilateral shoulders and hands as the major symptom and also had cognitive and emotional abnormalities for more than 1 year, who was diagnosed as cerebral hepatolenticular degeneration (HLD) in Tongji Hospital of Huazhong University of Science and Technology in October 2021. The serum ceruloplasmin and urine copper levels of the patient were 0.023 g/L and 3760.00 μg/24 h, respectively, and the Kayser-Fleischer (K-F) ring was seen in the cornea. Genetic testing revealed a homozygous mutation of ATP7B gene c.2975C>T (p.Pro992Leu), while transcranial sonography (TCS) showed lenticular nucleus hyper-echogenicity. The literature was searched using hepatolenticular degeneration and transcranial sonography as key words; and 9 articles involving 150 HLD cases were obtained. The lenticular nucleus hyper-echogenicity was presented in 76.9% HLD patients (150/195), while only in 12.7% healthy subjects (17/134) ( P<0.001), suggesting that advanced transcranial sonography can detect the metal deposition and may be used for diagnosis of cerebral HLD.

Methylated CpG dinucleotides in the 5-α reductase 2 gene may explain finasteride resistance in benign prostatic enlargement patients / 亚洲男科学杂志(英文版)

The inhibition of 5-α reductase type 2 (SRD5A2) by finasteride is commonly used for the management of urinary obstruction resulting from benign prostatic enlargement (BPE). Certain BPE patients showing no SRD5A2 protein expression are resistant to finasteride therapy. Our previous work showed that methylated cytosine-phosphate-guanine (CpG) islands in the SRD5A2 gene might account for the absence or reduction of SRD5A2 protein expression. Here, we found that the expression of the SRD5A2 protein was variable and that weak expression of the SRD5A2 protein (scored 0-100) occurred in 10.0% (4/40) of benign adult prostates. We showed that the expression of SRD5A2 was negatively correlated with DNA methyltransferase 1 (DNMT1) expression. In vitro SRD5A2-negative BPH-1 cells were resistant to finasteride treatment, and SRD5A2 was re-expressed in BPH-1 cells when SRD5A2 was demethylated by 5-Aza-2'-deoxycytidine (5-Aza-CdR) or N-phthalyl-L-tryptophan (RG108). Furthermore, we determined the exact methylation ratios of CpG dinucleotides in a CpG island of SRD5A2 through MassArray quantitative methylation analysis. Ten methylated CpG dinucleotides, including four CpG dinucleotides in the promoter and six CpG dinucleotides in the first exon, were found in a CpG island located from -400 bp to +600 bp in SRD5A2, which might lead to the silencing of SRD5A2 and the absence or reduction of SRD5A2 protein expression. Finasteride cannot exert a therapeutic effect on patients lacking SRD5A2, which may partially account for the resistance to finasteride observed in certain BPE patients.

Effect of imperatorin on airway inflammation of asthmatic mice model by Nrf2/HO-1 anti-oxidant pathway / 中草药

Objective To explore the therapeutic effect of imperatorin (IMP) in the asthmatic mice model, and study whether its mechanism is related to Nrf2/HO-1 signaling pathway. Methods A total of 50 male BALB/c mice were randomly divided into five groups, namely the control group, the OVA asthma model group, and the IMP low, medium and high dose treatment groups (15, 30, and 60 mg/kg). HE, Masson, and PAS staining were used to observe lung histopathological changes in mice; ELISA was used to detect the contents of IL-4, IL-5, IL-13, IFN-γ, and IgE in the BALF of mice; DHR-123 was used to detect the content of ROS in the mice BALF; The expression levels of protein carbonyl and MDA in lung tissues of mice were measured; The anti-oxidant enzyme kit was used to detect SOD, GSH, and total antioxidant capacity (TAOC) in BALF; immunohistochemical method was used to detect the expression levels of Nrf2 and HO-1 in lung tissues; The contents of Nrf2 and HO-1 in lung tissues were quantitatively analyzed by Western blotting. Results Compared with the model group, IMP reduced the exudation of inflammatory cells, the proliferation of goblet cells, and collagen deposition; IMP reduced the expression of ROS, total IgE, and OVA specific IgE in BALF; IMP decreased the contents of IL-4, IL-5, IL-13, protein carbonyl, and MDA, and increased the content of IFN-γ, SOD, GSH, and TAOC; The results of immunohistochemistry indicated that IMP increased the expression of Nrf2 and HO-1 in lung tissues; Western blotting showed that IMP induced Nrf2 nuclear translocation and the expression of HO-1 at the protein level. Conclusion IMP plays a therapeutic role in asthmatic mice induced by OVA, and its mechanism may be related to the activation of Nrf2/HO-1 pathway.

Frenulum identification positioning with a disposable suture device in circumcision to prevent postoperative penile frenulum malposition / 中华男科学杂志

Objective@#To investigate the effect of the frenulum identification positioning method with a disposable suture device in circumcision for the prevention of postoperative penile frenulum malposition.@*METHODS@#Totally 212 patients with phimosis or redundant prepuce underwent circumcision from March 2015 to September 2016, including 109 cases of conventional circumcision (the control group) and 103 cases treated by frenulum identification positioning with a disposable suture device (the observation group). We observed the postoperative position of the penile frenulum and median raphe and compared the deviation angles of the frenulum between the two groups of patients.@*RESULTS@#The median of penile frenulum deviation angle (interquartile range) was 0 (3.56) in the observation group, significantly smaller than 12.41 (19.59) in the control (P <0.001, P = 0.000). And the rate of frenulum deviation was remarkably lower in the former (8.74% ［9/103］) than in the latter group (66.06% ［72/109］) (P <0.01).@*CONCLUSIONS@#Circumcision using the frenulum identification positioning method with a disposable suture device can effectively avoid postoperative penile frenulum malposition. With the advantages of safety and easy operation, it deserves clinical application and popularization.

A new method for evaluating regional cerebral blood flow changes: Laser speckle contrast imaging in a C57BL/6J mouse model of photothrombotic ischemia / 华中科技大学学报（医学）（英德文版）

The present study aimed to improve the processing of data acquired from laser speckle contrast imaging (LSCI) to provide a standardization method to explore changes in regional cerebral blood flow (rCBF) and to determine the correlations among rCBF, cerebral ischemic lesion volume and microvascular density over time in a focal ischemic region. C57BL/6J mice were subjected to focal photothrombotic (PT) ischemia. rCBF was measured using LSCI at different time points before and after PT ischemia through an intact skull. Standardized rCBF (SrCBF), defined as the ratio of rCBF measured in the ipsilateral region of interest (ROI) to that in the corresponding contralateral region, was calculated to evaluate potential changes. In addition, the volume of the ischemic lesion and the microvascular density were determined using Nissl staining and immunofluorescence, respectively. The relationships among the ischemic lesion volume, microvascular density and SrCBF were analyzed over time. The results showed that the cortical rCBF measured using LSCI following PT ischemia in the C57BL/6J mice gradually increased. Changes in the cerebral ischemic lesion volume were negatively correlated with SrCBF in the ischemic region. Changes in the microvascular density were similar to those observed in SrCBF. Our findings indicate that LSCI is a practical technique for observing changes in murine cortical rCBF without skull opening and for analyzing the relationships among the ischemic lesion volume, microvascular density and SrCBF following focal cerebral ischemia. Preliminary results also suggest that the use of LSCI to observe the formation of collateral circulation is feasible.

Treatment of severe, disabling spasticity with continuous intrathecal baclofen therapy following acquired brain injury: the experience of a tertiary institution in Singapore

<p><b>INTRODUCTION</b>Intrathecal baclofen (ITB) therapy is a proven, effective treatment for disabling cortical spasticity. We describe the first local series of five patients with acquired brain injury (ABI) who received ITB and were followed up for 63.8 months.</p><p><b>METHODS</b>A retrospective review of medical and rehabilitation records of patients who received ITB therapy was carried out. Data studied included baseline demographic and injury variables, implantation data, spasticity and function, ITB dosage over time and complications.</p><p><b>RESULTS</b>From 2006 to 2010, a total of five patients received ITB therapy via implanted pumps about 39.4 months after ABI. Four out of five patients experienced significant reductions in their lower limb spasticity scores and improvements in global function and dependency. One patient had minor adverse events associated with baclofen-related sedation. The mean ITB dose at one year was 182.7 ± 65.6 mcg/day.</p><p><b>CONCLUSION</b>Our preliminary study showed encouraging long-term outcomes and safety for ITB therapy after ABI-related intractable spasticity. Individual ITB responses over time were variable, with gender differences. The outcomes experienced by our centre were comparable to those in the general ABI population, supporting the efficacy of ITB therapy for chronic disabling spasticity.</p>

A new method for evaluating regional cerebral blood flow changes: Laser speckle contrast imaging in a C57BL/6J mouse model of photothrombotic ischemia / 华中科技大学学报（医学）（英德文版）

The present study aimed to improve the processing of data acquired from laser speckle contrast imaging (LSCI) to provide a standardization method to explore changes in regional cerebral blood flow (rCBF) and to determine the correlations among rCBF, cerebral ischemic lesion volume and microvascular density over time in a focal ischemic region. C57BL/6J mice were subjected to focal photothrombotic (PT) ischemia. rCBF was measured using LSCI at different time points before and after PT ischemia through an intact skull. Standardized rCBF (SrCBF), defined as the ratio of rCBF measured in the ipsilateral region of interest (ROI) to that in the corresponding contralateral region, was calculated to evaluate potential changes. In addition, the volume of the ischemic lesion and the microvascular density were determined using Nissl staining and immunofluorescence, respectively. The relationships among the ischemic lesion volume, microvascular density and SrCBF were analyzed over time. The results showed that the cortical rCBF measured using LSCI following PT ischemia in the C57BL/6J mice gradually increased. Changes in the cerebral ischemic lesion volume were negatively correlated with SrCBF in the ischemic region. Changes in the microvascular density were similar to those observed in SrCBF. Our findings indicate that LSCI is a practical technique for observing changes in murine cortical rCBF without skull opening and for analyzing the relationships among the ischemic lesion volume, microvascular density and SrCBF following focal cerebral ischemia. Preliminary results also suggest that the use of LSCI to observe the formation of collateral circulation is feasible.

Unilateral external fixation assisted with closed reduction and interlocking intramedullary nail fixation for the treatment of comminuted fracture of femoral shaft / 中国骨伤

<p><b>OBJECTIVE</b>To introduce the use of single arm external fixation assisted reduction and closed complex intramedullary nail fixation for the treatment of femoral shaft fracture operation method and to study its effects.</p><p><b>METHODS</b>From June 2008 to October 2012, 24 patients with femoral shaft fractures were treated with unilateral external fixation assisted by closed reduction, interlocking intramedullary nail fixation. Among the patients, 19 patients were male and 5 patients were female, ranging in aged from 20 to 68 years,with an average of 45.6 years old. The fracture was caused by traffic accidents in 14 cases, by falling in 6 cases, by heavy bruising in 4 cases. Admission diagnosis was femoral shaft fracture. Operation was performed after traction from tibial tubercle for about 1 week.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 6 to 24 months, with a mean of 16.2 months. The X-ray showed fracture healing time ranging from 11 to 17 weeks, with an average of 13.8 weeks. All fractures healed without nails broken or close joint dysfunction. According to femoral shaft efficacy evaluation standards, 23 patients got an excellent result, 1 good.</p><p><b>CONCLUSION</b>Unilateral fixator assisted closed reduction and interlocking intramedullary nail fixation for the treatment of femoral shaft fracture has following advantages: less trauma, simple operation, effective reduction, high rate of fracture healing, and low complication rate.</p>

Influence of visual and auditory masking on the brain glucose metabolism in an idiopathic tinnitus patient / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the influence of the audio-visual block (AB) on the brain glucose metabolism of idiopathic tinnitus patients.</p><p><b>METHODS</b>The brain positron emission tomography (PET) test was performed on one chronic idiopathic tinnitus patient under audio-visual block and non-block (NB) conditions respectively. The visual analysis and statistical parameter mapping (SPM) analysis were both used to detect the brain glucose metabolism difference under AB and NB conditions.</p><p><b>RESULTS</b>Under NB conditions, significant hyperactivity was detected at auditory and visual cortex on both sides of the brain. However, this phenomenon was not shown under AB conditions. Instead, a hyperactivity of brain was presented in the left Wernicke's area.</p><p><b>CONCLUSIONS</b>The generation of chronic idiopathic tinnitus probably has no relationship with the auditory cortex abnormity. Wernicke's area might be involved in the central perception of tinnitus.</p>

18F-FDG uptake changes in the brain functional loop in patients with refractory obsessive compulsive disorder / 中华核医学杂志

Objective To investigate the glucose metabolic pattern of brain functional loop in patients with refractory obsessive compulsive disorder (OCD) using 18 F-FDG PET.Methods Eight patients with refractory OCD and 8 age- and gender-matched healthy volunteers underwent 18F-FDG PET brain imaging.SPM software was used for image post-processing and quantitative analysis.Correlation analysis between 18F-FDG uptake and Yale-Brown obsessive compulsive scale(Y-BOCS) score was performed.Results Compared with the controls,the glucose metabolism of bilateral frontal cortices ( including the rectal gyrus,orbital gyrus and cingulate gyrus),left thalamus,right temporal lobe and bilateral cerebellum in refractory OCD patients increased significantly ( Zmax =3.45 - 5.80,all P ＜ 0.001 ).Bilateral motor cortices and bilateral parietal lobes (BA7),however,showed decreased glucose metabolism (Zmax =3.44 - 4.46,all P ＜0.001 ).Y-BOCS score was positively correlated with the glucose metabolism of the bilateral anterior cingulate cortex (Zmax =3.77,3.48 and 2.97,all P ＜ 0.01 ).Conclusions There is a characteristic metabolic pattern of increased glucose utilization in the fronto-striato-thalamic loop and decreased glucose utilization in bilateral motor cortices and parietal lobes in patients with OCD.The glucose metabolism in the anterior cingulate cortex might serve as a quantitative parameter for the assessment of the severity of OCD.

Synthesis of opiate receptor radioligand 11C-carfentanil and its biodistribution in rats / 中华核医学杂志

Objective To establish an automatic synthesis method for 11C-carfentanil (CFN) as an novel opiate receptor radioligand and study its biodistribution in rats. Methods 11C-Triflate-CH3 was bubbled into 0.5 mg precursor desmethyl-CFN (which was dissolved in 0.15 ml DMSO) to generate 11C-CFN in a V-tube at room temperature. Sep-Pak C2 column was used for purification of 11C-CFN, which was eluted by 3ml binary system aqueous solution, 10 ml water thrice, and then I ml ethanol. The biodistribution (% ID/g) of 11C-CFN in SD rats was studied. SPSS 13.0 was used for statistical analysis. Non-normal distribution data were analyzed using nonparametric test. Results The synthesis time for 11C-CFN was 20 min (end of bombardment, EOB). The synthesis yield was (35.5 ± 2.2) % on average (n = 12, uncorrected)with the radiochemical purity over 98%. Biodistribution study in rats showed that the tracer had a high brain uptake, rapid blood clearance, and a metabolic pathway via liver and kidney. The highest tracer uptake was in thalamus (4.26 ± 0.89) % ID/g and striatum (4.05 ± 1.08) % ID/g at 5 min after injection, followed by cerebral cortex (2.63±0.89) %ID/g, pons (2.26 ±0.57) % ID/g, hippocampus (2. 17 ±0.55) %ID/g and cerebellum (2. 15 ±0.39) %ID/g. Conclusions The automatic synthesis of 11C-CFN is fast and reliable, and this radioligand can be used for opiate receptor imaging.

Use of laser speckle imaging to study effects of urinary kallidinogenase on cerebral blood flow following cerebral infarction in rats / 中华神经科杂志

Objective To study the effects of urinary kallidinogenase (kallikrein) on focal cerebral blood flow (CBF) following cerebral infarction in rats by laser speckle imaging.Methods Permanent middle cerebral artery occlusion (MCAO) was induced in male Sprague-Dawley rats by the intraluminal filament technique.Laser speckle imaging was used to measure CBF in the ischemic cortical area and middle cerebral artery territory.The brain was stained with 2,3,5-triphenyltetrazolium chloride (TTC) to determine the infarct size.Neurological deficit score was measured.Results CBF increased in both hemispheric cortical area and MCA territory on the first and second days following urinary kallikrein administration at high dose but not at low dose.Larger blood vessel diameter and increased blood flow velocity were noticed in the high dose group in some arteries when compared to the low dose group and normal saline control group.At 36 h after cerebral ischemia,the brain infarct size was 10.14% ±3.02% ,25.99% ±3.90% and 27.10% ±3.32% in high, low dose and normal saline control groups,respectively.The infarct size was significantly smaller in the high ( F = 61.14, P<0.01 ) but not low dose group when compared to the normal saline control group.The neurological deficit was milder in the high dose group but not the other two groups at 4 h after cerebral ischemia; however, there were no differences among the groups at 36 h after MCAO.Conclusions Urinary kallidinogenase can reduce cerebral infarction volume and neurological deficit in rats following focal cerebral ischemia.These effects may be attributed to enhanced collateral circulation and improved CBF in the hemispheric cortical area and MCA territory.

Diagnostic value of double contrast-enhanced ultrasonography in preoperative staging of gastric cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the clinical value of double contrast-enhanced ultrasonography using oral and intravenous contrast agents in preoperative staging of gastric cancer.</p><p><b>METHODS</b>Sixty-two patients with biopsy-proven gastric cancer were enrolled into this study, and were examined by double contrast-enhanced gastric ultrasonography preoperatively. The results were compared with postoperative pathologic findings.</p><p><b>RESULTS</b>The accuracy of oral contrast-enhanced gastric ultrasonography and double contrast-enhanced ultrasonography in determining the T stage of gastric cancer was 72.9% (T1: 66.7%, T2: 60.0%, T3: 76.9%, T4: 71.4%) and 88.1% (T1: 66.7%, T2: 80.0%, T3: 89.7%, T4: 100%), respectively, with a statistically significant difference between the two methods (P = 0.036). The sensitivity, specificity, accuracy and Youden index of oral contrast-enhanced gastric ultrasonography and double contrast-enhanced ultrasonography in assessment of lymph node metastasis were 74.5%, 66.7%, 72.9%, and 0.41 versus 89.4%, 75.0%, 86.4%, 0.76, respectively. No significant difference in the accuracy of assessment for lymph node metastasis was observed (P > 0.05).</p><p><b>CONCLUSION</b>Double contrast-enhanced ultrasonography is useful for preoperative staging of gastric cancer, especially for T staging.</p>

Design and simulation of interference current therapeutic instruments based on FPGA / 中国医疗器械杂志

This paper applies the DDFS theory, uses the method based on the Look-Up-Table, and designs an interference current therapeutic instrument with the automatic frequency scanning module and DDFS module to generate two different interference currents. The design of every module and the whole system are simulated by quartus II, the result shows that the design principle is correct and feasible, and worthy of applications.